The ALMA Scorecard for Action and Accountability is being adapted at the Regional level, primarily for use by country Ministries of Health led by Ministers. Existing regional-level coordinating mechanisms, such as Regional Economic Communities (RECs), are used to implement the regional scorecards. Regional scorecards include a mix of indicators reflecting both the strategic and operational environment for malaria control/elimination in the region. Prominent, are indicators related to cross-border and region-wide collaboration and coordination. Working with RECs, ALMA has supported the development of regional scorecards including the E8 Scorecard, launched in 2016 by SADC for Elimination 8 countries.